Simple Tools for Surgeons: Design and Evaluation of mechanical alternatives for robotic instruments for Minimally Invasive Surgery

摘要

Performing complex tasks in Minimally Invasive Surgery (MIS) is demanding due to a disturbed hand-eye co-ordination, the application of non-ergonomic instruments with limited number of degrees of freedom (DOFs) and the two-dimensional (2D) view controlled by the surgical assistance. Robotic camera holders and tele-manipulatory systems enhance surgical dexterity by providing the surgeon with 3D perception an instruments with up to 7 DOFs. They allow the surgeon to operate in an ergonomically favourable position with more intuitive manipulation of the instruments. Robotic systems, however, are very bulky, expensive and do not provide any force feedback from the tissue Therefore routine MIS with these robotic systems is not common use. The main objective of this research project is to provide surgeons with simple surgical solutions, which at least partly fill the gap between conventional endoscopy and the highly technological robotic systems. To do so, we have developed and evaluated solutions, which provide the surgeon with direct and intuitive control of the endoscope and surgical instruments with extra degrees of freedom, relative to conventional endoscopic instruments. We have developed and evaluated a mechanical, spring-balanced camera holder as an alternative for the robotic electromechanical systems and we have developed and evaluated a mechanical manipulator for MIS as an economical alternative for the DaVinci telemanipulator, providing the surgeon, just like the DaVinci, with intuitive manipulation and 7 DOFs at the instrument tip, and in addition limited force feedback.